Individual
JOHN CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11885 E 12 MILE RD STE 300A, WARREN, MI 48093-3467
(586) 582-6630
Mailing address
8390 ISLANDVIEW CT, BRIGHTON, MI 48114-8789
(810) 908-8757
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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